Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization: Secondary Analysis of a Randomized Clinical Trial
Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear. To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer. Infants...
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| Published in: | JAMA pediatrics Vol. 170; no. 9; p. 840 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
01.09.2016
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| ISSN: | 2168-6211, 2168-6211 |
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| Abstract | Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.
To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer.
Infants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)-confirmed influenza illness. In a secondary analysis of a subset of infants, hemagglutination inhibition (HAI) antibodies were measured. The study was performed at a single center in South Africa. The secondary analysis was performed in October 2014.
Maternal immunization for influenza.
The vaccine's efficacy against PCR-confirmed influenza illness and the percentage of infants with HAI titers of 1:40 or more by age group.
There were 1026 infants (47.2% female) born to IIV3 recipients and 1023 infants (47.3% female) born to placebo recipients who were included in the analysis of the vaccine's efficacy. The vaccine's efficacy against PCR-confirmed influenza illness was highest among infants 8 weeks of age or younger at 85.6% (95% CI, 38.3%-98.4%) and decreased with increasing age to 25.5% (95% CI, -67.9% to 67.8%) among infants 8 to 16 weeks of age and to 30.3% (95% CI, -154.9% to 82.6%) among infants 16 to 24 weeks of age. Similarly, in the IIV3 group, the percentage of infants with HAI titers of 1:40 or more to the influenza vaccine strains decreased from more than 56% in the first week of life to less than 40% at 16 weeks of age and less than 10.0% at 24 weeks of age.
Maternal immunization conferred protection against infection in the infants for a limited period during early life. The lack of protection beyond 8 weeks of age correlated with a decrease in maternally derived antibodies.
clinicaltrials.gov Identifier: NCT01306669. |
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| AbstractList | Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.
To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer.
Infants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)-confirmed influenza illness. In a secondary analysis of a subset of infants, hemagglutination inhibition (HAI) antibodies were measured. The study was performed at a single center in South Africa. The secondary analysis was performed in October 2014.
Maternal immunization for influenza.
The vaccine's efficacy against PCR-confirmed influenza illness and the percentage of infants with HAI titers of 1:40 or more by age group.
There were 1026 infants (47.2% female) born to IIV3 recipients and 1023 infants (47.3% female) born to placebo recipients who were included in the analysis of the vaccine's efficacy. The vaccine's efficacy against PCR-confirmed influenza illness was highest among infants 8 weeks of age or younger at 85.6% (95% CI, 38.3%-98.4%) and decreased with increasing age to 25.5% (95% CI, -67.9% to 67.8%) among infants 8 to 16 weeks of age and to 30.3% (95% CI, -154.9% to 82.6%) among infants 16 to 24 weeks of age. Similarly, in the IIV3 group, the percentage of infants with HAI titers of 1:40 or more to the influenza vaccine strains decreased from more than 56% in the first week of life to less than 40% at 16 weeks of age and less than 10.0% at 24 weeks of age.
Maternal immunization conferred protection against infection in the infants for a limited period during early life. The lack of protection beyond 8 weeks of age correlated with a decrease in maternally derived antibodies.
clinicaltrials.gov Identifier: NCT01306669. Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.IMPORTANCEInfluenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.To evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer.OBJECTIVETo evaluate the duration of infant protection conferred by maternal immunization and its association with transplacental antibody transfer.Infants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)-confirmed influenza illness. In a secondary analysis of a subset of infants, hemagglutination inhibition (HAI) antibodies were measured. The study was performed at a single center in South Africa. The secondary analysis was performed in October 2014.DESIGN, SETTING, AND PARTICIPANTSInfants born to women who participated in a randomized, double-blind, placebo-controlled clinical trial in 2011 and 2012 on the safety, immunogenicity, and efficacy of trivalent inactivated influenza vaccine (IIV3) during pregnancy were followed up during the first 6 months of life for polymerase chain reaction (PCR)-confirmed influenza illness. In a secondary analysis of a subset of infants, hemagglutination inhibition (HAI) antibodies were measured. The study was performed at a single center in South Africa. The secondary analysis was performed in October 2014.Maternal immunization for influenza.EXPOSUREMaternal immunization for influenza.The vaccine's efficacy against PCR-confirmed influenza illness and the percentage of infants with HAI titers of 1:40 or more by age group.MAIN OUTCOMES AND MEASURESThe vaccine's efficacy against PCR-confirmed influenza illness and the percentage of infants with HAI titers of 1:40 or more by age group.There were 1026 infants (47.2% female) born to IIV3 recipients and 1023 infants (47.3% female) born to placebo recipients who were included in the analysis of the vaccine's efficacy. The vaccine's efficacy against PCR-confirmed influenza illness was highest among infants 8 weeks of age or younger at 85.6% (95% CI, 38.3%-98.4%) and decreased with increasing age to 25.5% (95% CI, -67.9% to 67.8%) among infants 8 to 16 weeks of age and to 30.3% (95% CI, -154.9% to 82.6%) among infants 16 to 24 weeks of age. Similarly, in the IIV3 group, the percentage of infants with HAI titers of 1:40 or more to the influenza vaccine strains decreased from more than 56% in the first week of life to less than 40% at 16 weeks of age and less than 10.0% at 24 weeks of age.RESULTSThere were 1026 infants (47.2% female) born to IIV3 recipients and 1023 infants (47.3% female) born to placebo recipients who were included in the analysis of the vaccine's efficacy. The vaccine's efficacy against PCR-confirmed influenza illness was highest among infants 8 weeks of age or younger at 85.6% (95% CI, 38.3%-98.4%) and decreased with increasing age to 25.5% (95% CI, -67.9% to 67.8%) among infants 8 to 16 weeks of age and to 30.3% (95% CI, -154.9% to 82.6%) among infants 16 to 24 weeks of age. Similarly, in the IIV3 group, the percentage of infants with HAI titers of 1:40 or more to the influenza vaccine strains decreased from more than 56% in the first week of life to less than 40% at 16 weeks of age and less than 10.0% at 24 weeks of age.Maternal immunization conferred protection against infection in the infants for a limited period during early life. The lack of protection beyond 8 weeks of age correlated with a decrease in maternally derived antibodies.CONCLUSIONS AND RELEVANCEMaternal immunization conferred protection against infection in the infants for a limited period during early life. The lack of protection beyond 8 weeks of age correlated with a decrease in maternally derived antibodies.clinicaltrials.gov Identifier: NCT01306669.TRIAL REGISTRATIONclinicaltrials.gov Identifier: NCT01306669. |
| Author | Madimabe, Richard Jones, Stephanie Weinberg, Adriana Cutland, Clare L Madhi, Shabir A Hugo, Andrea Simões, Eric A F Nunes, Marta C |
| Author_xml | – sequence: 1 givenname: Marta C surname: Nunes fullname: Nunes, Marta C organization: Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa2Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa – sequence: 2 givenname: Clare L surname: Cutland fullname: Cutland, Clare L organization: Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa2Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa – sequence: 3 givenname: Stephanie surname: Jones fullname: Jones, Stephanie organization: Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa2Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa – sequence: 4 givenname: Andrea surname: Hugo fullname: Hugo, Andrea organization: Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa2Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa – sequence: 5 givenname: Richard surname: Madimabe fullname: Madimabe, Richard organization: Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa2Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa – sequence: 6 givenname: Eric A F surname: Simões fullname: Simões, Eric A F organization: Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa3Department of Pediatrics, University of Colorado and Center for Global Health, Aurora – sequence: 7 givenname: Adriana surname: Weinberg fullname: Weinberg, Adriana organization: Departments of Pediatrics, Medicine, and Pathology, University of Colorado, Aurora – sequence: 8 givenname: Shabir A surname: Madhi fullname: Madhi, Shabir A organization: Department of Science and Technology/National Research Foundation, Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa2Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa5National Institute for Communicable Diseases, Division of National Health Laboratory Service, Centre for Vaccines and Immunology, Johannesburg, South Africa |
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| Snippet | Influenza immunization of women during pregnancy protects the young infants against influenza illness. The duration of this protection remains unclear.
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| SubjectTerms | Adult Double-Blind Method Female Humans Infant, Newborn - immunology Influenza Vaccines - immunology Influenza, Human - immunology Influenza, Human - prevention & control Male Maternal-Fetal Exchange Placenta Polymerase Chain Reaction Pregnancy Pregnancy Complications, Infectious - immunology Pregnancy Complications, Infectious - prevention & control Pregnancy Outcome South Africa |
| Title | Duration of Infant Protection Against Influenza Illness Conferred by Maternal Immunization: Secondary Analysis of a Randomized Clinical Trial |
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